The Push for a 'Paradigm Shift'

A good starting point is this observation from Scott Schneider, director of the Laborers' Health and Safety Fund of North America's Occupational Safety and Health Division: "The problem is OSHA is a small agency with a small budget and a huge mission. They have to figure out creative ways to leverage their resources and get employers to improve safety conditions on their job sites."

Creative or not, 40 years of rulemaking, inspecting, training, allying, encouraging, advising, and punishing by OSHA have built an impressive body of work in many ways. Its weaknesses are apparent and stem from its establishing law, as well as from an often-hostile Congress and lawsuits at key moments.

The agency's assistant secretary, Dr. David Michaels, commented May 18 at the AIHce conference about OSHA's current challenge "to figure out how to do what we do even better than before in an era of fewer resources," adding, "There will always be budget issues." To illustrate, he said total federal and state safety enforcement personnel now number about 2,200, or 23 for every 1 million U.S. workers -- down from 37 per million in the 1970s.

"We have saved thousands and thousands of lives. . . . We've prevented many injuries. It's not that OSHA alone has done this -- we've done it together," Michaels told the assembled industrial hygienists and safety professionals. His chart showed 18 workers died on the job per 100,000 workers in America in 1970, but the rate had plunged to 3.5 per 100,000 by 2009. Still, about 4,300 occupational fatalities occurred in the United States in 2009. He reminded the audience that occupational deaths are, unlike occupational injuries, accurately recorded. "It's still too many," he said, "but we've made great progress."

Before OSHA existed, asbestos, lead, and benzene workplace exposures were uncontrolled, and grain bin explosions and excavation/trenching fatalities were much more common than they are today. He said grain bin explosions have declined by 42 percent since the grain handling standard was promulgated in 1987, and excavation/trenching deaths are down 35 percent since that 1989 standard.

"We made a tremendous amount of progress in the last 40 years, and I'll think we'll make even more in the next 40 years," Schneider said. "I think it's going to take a lot of work and a lot of creative thinking to figure out how to do that effectively. Usually as with anything, the first gains are easier, then it gets harder to make progress. If you look at OSHA's budget, it has not gone up if you account inflation; it hasn't gone up in almost 40 years.

"I think the various health and safety standards they've published have made a big difference" to construction workers, he continued. "They set a standard and, by and large, the industry comes into compliance with it. For example, I worked on the asbestos standard back in the '80s, and I think it's probably prevented a lot of asbestos-related disease. The fall prevention standards, the scaffolding standards, the training standards, I think it's saved a lot of lives and prevented a lot of illnesses and injuries."

Silica is one of the biggest construction worker safety issues at present, Schneider said, and OSHA is about to address it by lowering its conflicting Permissible Exposure Limits for silica exposure. "It's a major hazard for a lot of construction workers, and we're hoping that by putting out a standard, it'll help reduce the risk of silica-related disease among construction workers," said Schneider. "Back in the 1930s, the secretary of labor said that she wanted to stop silicosis, this lung disease from silica exposure, from ever occurring among workers in this country. Here we are, 73 years later, and we're still working on this. It's about time that we finally tackled this problem and prevented these illnesses from occurring."

He said OSHA's biggest challenges are its budget and the prolonged regulatory process it must employ. "The third thing is how do you reach small employers, who are often below the radar? How do deal with issues like immigrant workers? How do you affect safety culture? Safety culture is something that is very difficult to regulate, particularly small employers who don’t have a lot of resources. They have a lot of work to do.

"I think OSHA has made a tremendous contribution to this country," Schneider said. "I hope they can get more support than they have. I think sometimes the agency gets vilified, but it's unjust. I think they do a tremendous job, and they need more public support and more support from the safety and health community and from industry. I think we'd be much worse off without OSHA."

I2P2 and Future StandardsOpposition developed early to Michaels' top priority, the Injury and Illness Prevention Programs (I2P2) standard, which will undergo the required small business impact analysis this summer.

A questioner asked him how I2P2 would work on multi-employer sites and suggested that the standard require sign-off lists in construction sites' job trailers to ensure new hazards, such as floor holes opened in a high rise or guardrails temporarily removed, are recognized and addressed. Michaels said he likes the idea. The question still to be answered is how prescriptive the standard should be, he added.

He says it is not intended as an enforcement tool. "We think employers should be implementing an injury and illness prevention program whether or not we have a standard," he said. "We don't plan to use the Injury and Illness Prevention Programs standard to say, 'You didn't abate a hazard.' It's really, 'Did you think about it?' We aren't going after a new tool to address hazards. It's a paradigm shift."

He said he wants to see I2P2 plans written down, shared within a company or a job site so the employees will understand it and know it, and then posted.

It's apparent that I1P2 is linked to OSHA's more aggressive enforcement approach under Michaels; it also is a core requirement of OSHA's VPP and SHARP programs. The agency hopes that its enforcement causes more employers to adopt injury and illness prevention plans, Region VI Acting Regional Administrator Bill Burke said May 23 at the NECA Safety Professionals Conference in Dallas.

Also on OSHA's priority list is modernizing injury and illness recordkeeping and reporting. "We're moving toward modernization of injury tracking, and if we do, we'll be able to target [inspections] much more effectively," Michaels said. He agreed when a questioner suggested developing "a very robust eTool" to improve recordkeeping and reporting.

In an interview, NIOSH Director Dr. John Howard said OSHA erred in its proposed redefinition of "feasible" engineering controls for noise by not providing the economic case for it immediately. "That business case for doing something that appears to be the right thing to do is often missing," Howard said. "The era is over where you can say, 'Oh, this is the right thing to do. Science says it's the right thing to do.' You've got to show that it's not going bankrupt everybody in the process and it's going to accomplish the task.

"It's a very difficult challenge. In safety and health, we haven't taken up that challenge enough. Even at NIOSH, when I came, it was pretty much not acceptable to be talking about the feasibility or the economic feasibility. 'We just give recommendations; we don't worry about that.' And I said to everybody, 'Well, that's fine, but how many people are really going to pay attention to your recommendations if you don't make the technical argument -- here's how you do it, technically -- and also the economic feasibility. If we want people to take up our guidance, our recommendations, you've got to go that extra mile.

"Now, that's more acceptable at NIOSH, and we do it routinely," he continued. "Where, several years ago, we just worried about what they should do. Now, we worry about whether they can do it and what it will cost them to do it. You can't really have an impact if folks aren't taking up your stuff. A lot of folks, they really need the whole plan worked out. You've got to give them a plan of how to put it all together."

In his April 2011 "From the Director's Desk" article, Howard mentioned not wanting to repeat past mistakes, such as widely using raw materials or techniques before their hazards are well understood. We asked during our April 19 interview whether he knew of an example where the science developed at the same time or even ahead of an industry's adoption of a raw material or technique. Is there a model industries should be following to accomplish this?

"It's hard to find those examples, and a think there's a lot of promise for the future in doing that better than we've done in the past,” he replied. “It depends on what you're talking about -- if it's a process versus an actual product. Processes sometimes and products are studied ahead of time, but it's usually not for the safety and health aspect of the product. It's for how the process works in the production sense, or how a product is going to fit into market share or fulfill a chain of product sales. The safety and health design aspects -- a manufacturer doesn't get a lot of sales or even price advantages by saying, 'My product is safer.'

"You see it in things that are already safety products: protective gear or a respirator, something like that. Now, in construction, you're starting to see ladder designers design things with more handles, so if somebody becomes unsteady, it locks on the ladder to lock it in place. You see that a little more, but those have usually come after something has clearly been identified as an unsafe product or a use you put them to results in problems. I'm waiting for somebody to design a nail gun that somehow senses that it's pointed at a person, and you fire it, and it just sort of plops out of the gun rather than being propelled into someone's head. Those kinds of products are yet to be marketed."

Collaborating Now, Communicating TomorrowNIOSH and OSHA are collaborating in many areas, notably in construction, where OSHA's directorate is now headed by Jim Maddux, who previously held several senior positions within OSHA (director of the Office of Physical Hazards, acting director of the Office of Engineering Safety, Office of Maritime director, acting deputy director for the Directorate of Standards and Guidance).

"Scarce resources, unfortunately, are a part of our life these days, and will be for a number of years. We're trying to figure out how we can work together better," Howard said. "We're doing a lot of activities together. We're starting to co-brand some construction brochures -- we're doing a nail gun co-branded brochure, OSHA/NIOSH. We get a lot of bang for the buck from our side because our research -- like what goes into the nail gun brochure -- when OSHA's name is on it, we get a little more attention. What we've been really happy about is, Dr. Michaels at OSHA has said, 'We at OSHA want to be a channel for your science, your research, and your solutions.' That has really gotten us very, very excited."

He said his agency "uses every conceivable channel" to encourage professional to use its research and materials such as National Occupational Research Agenda (NORA) documents, which are useful and thorough.

In a sign of social media's growing influence, NIOSH's Twitter site exceeded 100,000 followers earlier this year. "I think it's really been positive thing for us. We've just been amazed by the retweet rate, which gets up into the hundreds of thousands," said Howard. "We hope people then go further, read a little more, understand a little more, and then go to our website, pick up a brochure, make those changes. That part we haven't figured out how to measure yet."

NIOSH posted a survey asking readers of the its blog whether they'd made any change because of what they read there. (At this writing, some of the blog's most popular entries concerned body art, trucking, and music-induced hearing loss.)

How will NIOSH communicate with workers, safety and health professionals, and the public in 10 or 20 years? "I'm not sure," Howard said. "The only thing I know is that it's going to have to be shorter, pithier. People just do not have the attention and concentration any more. The idea of a website I think will still exist for people who want details, but I think to grab people's attention, it's going to have to be a very short message that will bring them in and move them somewhere else, depending on their needs. The other thing, we're going to have to think about how to become more interactive."

The Private Sector's RoleThe regulatory role performed by OSHA won't become extinct, he said. "I spent 10 years running a regulatory agency in California. I've always thought that the value of a regulation is to set a floor. [People ask,] 'If I do the regs, do I have a safe workplace?' You do the regs, and you've complied with the regs. You've assured yourself that if inspected, they can't cite you for failing to comply with the regs. But, I think any employer wants a safe workplace, and regs cover only a certain amount of that territory."

"No. I think you're always going to have to have regs to provide that floor. So you say, as a society, we don't want the employer behaving below that level. That's what a reg says. And then, I believe you have to augment that with very specialized encouragements through recommendations, and guidance, and other things, for employers who say, 'I want to do something more. I want a better workplace than I have.' And here's how government can help you do that.

"The private sector has a role. There are many, many private sector practitioners who do a fabulous job, using government materials and their own experience of how to do it. To me, it will always be a hybrid: It will be regulatory, and it will be also the extra mile that employers want to take. I'm sure you realize, too, that some things are just not amenable to a reg."

Nanotechnology, for example, will be difficult to regulate. "Very hard," Howard said. "But even harder than that are things dealing with human motivation. Psychiatrists don't understand why people do certain things. Looking at studies of criminal behavior, they're right about 50 percent of the time. So, you know, it's like a coin toss. This idea, then, for hazards in the workplace that arise from human motivation, like violence, I'm not sure you can do a reg that will cover that hazard. In the same way, it's very hard to do a reg covering ergonomic hazards because the risk factors for the production of an ergonomic injury -- force, and repetition, and posture -- they're also attributes of work: You can't do any work unless you assume some kind of posture and exert some kind of force and repeat it.

"So there's a lot of things that are very difficult to do a reg on. So OSHA, in the first 20 or 30 years, they've done a lot of regs. But those regs may be the ones [addressing hazards] that produce the most damage to people; they had the biggest risk. They maybe were the easiest ones to write.

"So I think that hybrid world that we're describing is going to be the world we're facing, and certainly internationally. We've got a lot of that going on in nano right now, where we've got a lot of international consensus standards that are being built, and there are no regs. Nobody's got a reg."

This article originally appeared in the July 2011 issue of Occupational Health & Safety.